System and Method for Propagation of Spine Labeling

ABSTRACT

A system and method of labeling orthogonal or otherwise spatially related image views and related images is provided. The present invention provides automated progression for the labeling of vertebral and inter-vertebral regions, propagation of labels between views and images within a series, centering of label regions relative to the spine, circular lists of predefined labels, and label displays for individual slices of an orthogonal or axial view as a user scrolls through the plurality of image slices of the given view. In a further aspect, the present invention provides automated labeling of vertebral and inter-vertebral regions when a user provides labels for the adjacent two inter-vertebral or vertebral regions.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/131,643, filed on May 27, 2011, now U.S. Pat. No. 8,463,010, which isa National Stage filing under 35 U.S.C. §371 of InternationalApplication No. PCT/US2009/065980, filed Nov. 25, 2009, which in turnclaims the benefit of U.S. Patent Application No. 61/118,582, filed Nov.28, 2008. All of the above-referenced patent applications are herebyincorporated by reference in their entirety.

FIELD OF THE INVENTION

The present invention is directed in general to imaging technologies andmore particularly to medical imaging and picture archiving andcommunication systems (PACS) having an image display wherein labeling ofthe image is desired. A system and method are provided to ease andimprove labeling of images, particularly spinal column images. Morespecifically, a system and method are provided for the automatedlabeling of spine images, alignment of such labels and the propagationof the labels between different views of the image, such that movementthrough orthogonal views of the images or slices of the subject, willdisplay appropriate labels. Users are able to quickly label images andmore accurately and consistently identify various regions of an imageirrespective of the viewing plane.

BACKGROUND OF THE INVENTION

In medical imaging, picture archiving and communication systems (PACS)are a combination of computers and/or networks dedicated to the storage,retrieval, presentation and distribution of images. While images may bestored in a variety of formats, the most common format for image storageis Digital Imaging and Communications in Medicine (DICOM). DICOM is astandard in which radiographic images and associated meta-data arecommunicated to the PACS system from imaging modalities for interactionby end-user medical personnel.

PACS display textual and graphical medical information that areassociated with image attributes. Some of this information is receivedfrom DICOM and some is generated within the PACS as annotations that areassociated with the images or measurements linked to anatomical regionsof interest or markers that are produced by third party systems, such asComputer Aided Detection (CAD) applications. The DICOM standard recentlyintroduced support for Structured Reports (SR) that can include CADfindings and GSPS (Grayscale SoftCopy Presentation State) non-imageobjects that are necessary to reproduce the same visualization of animage if displayed at two disparate PACS systems. Not all annotationsare covered under the GSPS umbrella and often these attributes aredisplayed as static image overlays that can be turned on or off, basedon the viewer's preference.

For example, certain attributes that are related to image processing aredisplayed as alphanumeric annotations that are associated with therendering of a particular image. The use of an image as a diagnostic oranalytical tool generally requires that images be labeled by appropriatemedical personnel. The labeling of images is accomplished by theannotation of points or regions, on a displayed image, with a descriptorsuch as a label. The descriptor may be user provided such as manuallytyped text/numbers or be predefined alphanumeric strings that areselectable by the user. All users are thus able to identify imageregions as a result of these labels.

Since an object or body part of interest will typically have multipleimages taken or generated from different perspectives or views (i.e.sagittal, transverse, orthogonal, curved MPR, etc.), it would bebeneficial for the labels to appear on the various views of the imageirrespective of the view that is being displayed. The labels thusprovide a reference point between the displayed images. Moreimportantly, it would be beneficial for the label of a particular regionto be propagated to all views and all images of that region within agiven system.

For example, in the area of spine labeling, text annotations areprovided in proximity to vertebral and inter-vetebral regions of animage of a spine, to serve as points of reference for any user viewingthe image. In the imaging process for the spine, a first image mayobtained in the sagittal plane, a second image or series of images maybe obtained in the orthogonal plane and a third series of other imagesmay be taken in the axial plane. The label for any particular vertebraein the first image is also required on the second and third series ofimages. Traditionally, this labeling process is manual in nature. Thatis, a user with the aid of a mouse or other pointing device locates avertebra in the first image, and then locates other instances of thatvertebra in the second and third series of images. This annotationprocess is very time consuming. Furthermore, this process is prone toerrors as the labels must be consistently placed in each of the imageswithin each of the series of images.

To overcome some of the deficiencies described above, some systems haveattempted to minimize the amount of manual effort that may be requiredto propagate spine labels between the different images and views.However, these systems suffer from drawbacks of their own. Thesesolutions utilize a single point label in one view of an image topropagate that label to an orthogonal view of the image, such as byfinding the single point of intersection of the orthogonal plane and thelabel point. One of many disadvantages and draw backs to this method isthe fact that such a system would not allow a continuous display oflabels as a user moves through the various slices of an orthogonal viewsince only the single slice that intersects the point on the sagittalview would have a label. Another disadvantage lies in the issue ofaccuracy in of the labeling of an orthogonal or axial slice. Since theplane of the axial slice may not exactly intersect the labeled point onthe sagittal view, some approximation of the proximity of the axialslice to the intersection point is required. This aspect would not onlyintroduce errors in labeling, but may also confuse or mislead a user whomay be expecting a label as a certain axial image view is displayed.

What is needed is an intuitive and quick method for labeling images thattranscends the problems highlighted above and provides a simplified yetefficient and reliable identification of image regions irrespective ofthe view that is displayed. In other words, a system that avoids thetedium of manual labeling, propagates labels to the various views andvarious related images in a series. The present invention fills theseneeds as well as other needs.

SUMMARY OF THE INVENTION

The present invention is directed to a system and method of labelingorthogonal or otherwise spatially related image views and relatedimages. The present invention provides automated progression for thelabeling of vertebral and inter-vertebral regions, propagation of labelsbetween views and images within a series, centering of label regionsrelative to the spine, circular lists of predefined labels, and labeldisplays for individual slices of an orthogonal or axial view as a userscrolls through the plurality of image slices of the given view.

The present invention also provides automated labeling of vertebral andinter-vertebral regions when a user provides labels for the adjacenttwo, inter-vertebral or vertebral, regions.

BRIEF DESCRIPTION OF THE DRAWINGS

The above-mentioned and other features and advantages of this invention,and the manner of attaining them, will become apparent and be betterunderstood by reference to the following description of the invention inconjunction with the accompanying drawing, wherein:

FIGS. 1A, 1B and 1C are line drawings of images that may besimultaneously displayed by a PACS in a single window that may bedivided into at least three regions;

FIG. 2 is a block diagram illustrating vertebral and inter-vertebralregions of a spine along with the labeling of those regions;

FIG. 3 is a flow diagram illustrating the steps for aligning the labelregions of the spine according to the present invention;

FIG. 4 is a block diagram illustrating image slices taken in the axialplane of the illustrated spine of FIG. 2;

FIG. 5A is an illustrative diagram of a spine column with a detectedcenter line and spine labeling cursor;

FIG. 5B is an illustrative diagram of a spine column with a detectedcenter line and a corrected center line;

FIG. 6 is a block diagram generally illustrating a computing environmentin which the invention may be implemented; and

FIG. 7 is an illustrative diagram of a detected spine segments.

DETAILED DESCRIPTION OF THE INVENTION

Generally, the system and methods described herein for creating andimplementing the labels may be implemented in hardware, software or acombination thereof. This document is organized as follows. In the firstsection, an overview of the techniques and implementation as provided byan exemplary PACS system in accordance with the present invention areprovided and described. In the next section, an exemplary implementationof particular features of the present invention for specifying,centering and propagating labels to various images is discussed.Following this, other aspects of the invention as they pertain to easeof use and tools of convenience, including automated and semi-automatedlabeling of images are discussed. Finally, an exemplary computerenvironment for the implementation and use of the invention isdescribed.

The present invention provides a system and methodology for labelingvertebral and inter-vertebral regions of spinal images with imageannotations. Although the following discussions and the presentinvention are described in relation to a biological imaging system(i.e., PACS), it should be understood that the invention is alsoapplicable to other information/imaging technologies and systems andimaging of other anatomical body parts.

An example is modality workstation which enables proper manipulation,preparation and clean-up of acquired image series before examination bythe radiologists. Another example is surgery planning or Orthopedictemplating software. Such systems include those wherein imagemanipulation, image attributes and features of an imaging system arerequired to be intuitively and easily marked or identified, includingnon-medical systems, visual analysis and diagnostic tools, and othervisual user interface environments. Further, the present invention isdescribed with reference to orthogonal and planar views, however, thesystem and method of the present invention is equally applicable tonon-orthogonal views and/or non planar views. Additionally, thisspecification describes labeling from the sagittal view for illustrativepurposes only. The use of one or more other views is within the scope ofthe present invention.

Referring to FIGS. 1A, 1B and 1C, an imaging system such as a PACSsystem provides in one aspect a window display 100 of images 101 a, 101b, 101 c to enable an end user such as a technician, radiologist orother qualified personnel, to review, analyze or diagnose a patient'scondition. Generally, one or more images of a target area of the bodyare captured by an imaging device such as an X-ray device,computer-tomography (CT) scanner, or magnetic resonance imaging (MRI)device. In order to provide a picture of the target, images of thetarget are acquired from multiple viewing planes. The images are usuallytaken in orthogonal planes and are typically presented to the user inthe single viewing window 100, wherein images 101 a, 101 b, 101 c may besimultaneously displayed. The window 100 may be split into regions A, B,and C for enabling the simultaneous display of the multiview images 101a, 101 b, 101 c. For example, region A, displays an image taken alongthe sagittal plane of a subject body. Region B, displays an image takenin the coronal plane of the subject body, and region C displays an axialplane view. As would be appreciated by one skilled in the art, thevarious image displays of the window 100 may be part of a series ofimages acquired from a particular view plane. For example, the displayedaxial view image of region C, is an image of a single slice in a seriesof multiple slices and images taken in the axial plane throughout thelength of the subject body.

In order to facilitate reference and identification of the parts of animage for the purpose of diagnosis or analysis of the subject, thevarious parts of the images of the window 100 need to be labeled. Morespecifically, and as shown in regions A, B, and C, the labels provide adefinitive reference to particular regions of the displayed spine. Thelabels are stored as annotative overlays of the image, thus allowinglater review and reference when the image is later displayed orotherwise presented. The present invention provides an improved andefficient system and method for labeling the images in the variousregions A, B, and C. It should be noted that the labels are volumetric.The displayed rectangle or circle is actually the cross section of alabel volume such as a rectangular prizm or a sphere that gets placed inthe 3D volume. The volume is then aligned with the center of thevertebrae using projection on the primal line that results from a spinedetection algorithm that is described in detail further in thisspecification. Alternatively, the user may manually define the vertebralcenter. It should be noted that the views of the 3D volume are notalways orthogonal and need not be planar. A curved multiplanarreconstruction view may be utilized.

In operation, and as best described with reference to the block diagram200 of FIG. 2, the present invention provides an improved and efficientmethod to label a vertebral column 201. As shown, the vertebral column201 includes vertebrae 202, 204, 206 and inter-vertebral discs 208, 210.In order to label the various section of the spinal column 201, a userwith the aid of a pointing device, such as a mouse with a thumb wheel,is able to switch into a labeling mode. In the labeling mode, either asingle identifier or a label is displayed. Alternatively, a list ofmultiple identifiers may be displayed for selection by the user. Ineither scenario, the user is able to dial through the available labelsto a desired label for tagging or otherwise identifying an image item.

In the case labeling of spinal vertebrae and inter-vertebrae, thepresented list of labels is configurable by the user to include one orall of the regional labels for the spinal column namely, cervical,thoracic, lumbar, and sacral regions (C1-C7, T1-T12, L1-L5 and S1-S5).The user may also select whether or not the presented label list willinclude both vertebral and inter-vertebral labels or just one or theother. These selectable options increase the efficiency and speed withwhich the user may locate labels of interest. Once a desired label islocated with the mouse wheel or right or left mouse click and drag basedon the configuration, the user is able to click on the relevant sectionof the image and place the label (i.e., the vertebra or disc), which inthe case of the present illustration and discussion is vertebra 202.

Generally, according to the system and method of the present invention,the mouse click results in a volumetric label based on a spherical,rectangular, or similar region 203 being overlaid on the image of thespinal column 201 in the user selected section of the image (i.e., on avertebra 202) along with the proper label, such as C1. The volumetricregion 203 defines a 3D label region on the target object for theboundaries of the vertebra 202 rather than merely a label point withinthe vertebra 202. By default configuration, in an embodiment of thepresent invention, when a user selects a vertebra as the target for alabel, a volumetric marker having a dimension of approximately radius(a) is placed on the vertebra. Conversely, when a disc is selected, avolumetric marker having a radius of approximately a/2 is overlayed onthe disc. It is implicit that the dimensions of these markers may be afunction of the anatomy being labeled, the level of magnification, andresolution of the image. Notwithstanding this, in a further embodimentof the invention, the dimensions and positions of the label region(i.e., the rectangle), is adjustable and sizeable by the user asrequired. Subsequent sections of the spinal column may be marked andlabeled as shown in FIG. 2.

Using the mouse or other user interface device, the user is able toidentify and mark the different parts of the spinal column 201. Thevertebra 202 is marked by a region 203 having a label C1, vertebra 204is marked by region 205 and a label C2. The inter-vertebra disc 208 issimilarly marked by region 209 and labeled C1/C2 and inter-vertebra disc210 is marked by regions 211 and labeled C2/C3. In a further embodimentof the present invention, an axis or center line 212 of the spinalcolumn is algorithmically determined and the various label regions 203,205, 209 and 211 are centered about the center line 212. This featureenables a well defined volume of the vertebrae or inter-vertebrae to beascertained and accordingly identified with each label.

The center line 212 is determined by application of logic illustrated inthe flow diagram of FIG. 3. The present invention, importantly, utilizesan algorithm to detect the approximate location of the center of thespinal cord and from there the central axis of each vertebrae. Thislocation is used to anchor the manual volume label provided by a user,back to where it really belongs. At step 302, a spinal cord region isdetected utilizing AdaBoost classifiers in each slice. As would beappreciated by one skilled in the art, other methods for defining aspinal location may also be employed without departing from the spiritand scope of the present invention. Next, an approximation of the centerline is made by a spline, at step 304. Following this, a sagittal CurvedPlanar Reformatted (CPR) image is generated utilizing the aforementionedspline, at step 306. Horizontal edge gradients are computed in the CPRat step 308. However, it should be understood that it is not necessaryto generate the CPR to take advantage of the present invention. Usingthe CPR would ensure that the spine will be visible at the vertebraecenters, and that the user will be able to label each vertebrae withoutthe need to adjust slice position to best place the labels. This isespecially helpful for labeling a vertabrae for a scoliosis patient or apatient that has severe arthritis related spinal deformation. However,even in the absence of the CPR, the location of vertebral axis acts likea reference axis to properly place labels created in a particular view(typically sagittal or coronal), to their proper 3D location.

Next, the spline of the spinal cord is transformed to fit the posterioredges of the spinal column, at step 310. A spline of the posteriorboundary of the spinal column is obtained at step 312. The spline of thespinal cord is transformed to fit the anterior edges of the spinalcolumn, at step 314. Following this, a spline of the anterior boundaryof the spinal column is obtained at step 316. Finally, at step 318, amiddle line of the splines of the posterior and anterior boundaries ofthe spinal column are determined to be the centerline.

In an embodiment of the present invention, the automated algorithm thatprovides the vertabral axis also provides a volume in the shape of acylindrical cube that closely surrounds and envelops the spinal column,thus providing further gains in user productivity.

The present invention implements a propagation of labels from one imageor view to all associated views and images in a series. Returning for amoment to the window 100 of FIG. 1. After an image in the sagittal view,such as shown in region A, has been successfully labeled, the presentinvention provides for the propagation of the labeling to the coronalview image shown in region B as well as to the axial view shown inregion C. Importantly, and as shown, the present invention labels avolume of the vertebra. In effect, the sagittal view of region Adisplays the x, y area of the labeled volume region and the coronal viewof region B displays the y, z area of the labeled volume region.

It should be noted that labels in the present invention are propagatedto the correct 3D location. More specifically, in two-dimensional PACS,when the user places a selection sphere marker on the coronal view forexample, an exact three-dimensional location is not defined. There ishigh likelihood that when viewed from the axial slice the marker may beoutside the vertebrae. The present invention ensures that by the usingthe spinal line, the labels are moved automatically in their currentthree-dimensional location without requiring the user to explicitly goto the axial and coronal views to adjust the placement.

As would be appreciated by one skilled in the art, there are multipleways to label the various views or images. The spinal line may beutilized to do CPR and label the image. The image navigation intwo-dimension can be constrained such that it resides on the spinalcolumn thereby making the labeling easier. Alternatively, labels couldbe moved to their correct three-dimensional location without anymodification to image navigation or the requirement for CPR. The latteris preferred method to introduce the feature of the present invention ina native two dimensional PACS. This feature enables faster labeling fromthe users perspective, particularly since the user can be sloppy andmove faster during the labeling process, as the algorithm will correctfor it. For example, while on an axial slice, the user can place thelabel of vertebrae and the sphere will be automatically centered aroundthe spinal axis by the present invention. In coronal and sagittal viewsthe user can place the label off the spine along a perpendicular line tothe spinal column and the label will be moved back automatically to thespinal line.

The labels of the present invention are propagated to any desired viewincluding volumetric rendering, such as the transverse or axial sliceshown in region C, which displays the x, z area. The displayed axialslice is one of several image slices that span the length of the spinalcolumn shown in sagittal view of region A. To best describe thepropagation of labeling to the axial plane view, attention should bedirected to the illustrations of FIGS. 2 and 4.

Images of the axial plane and images of the sagittal and coronal planeshave an orthogonal spatial relationship to one another. An axial sliceimage intersects the sagittal and coronal images at a line ofintersection. Each labeled region 203, 205, 209 in the sagittal andcoronal views represents a volume in the spinal column 201. As such, aperpendicular slice of the spinal column 201, such as indicated by thelines 1 through 10 in the drawing figure, will intersect a labeledregion 203, 205, 209, thus providing a label identification of eachslice. Consequently, as a user traverses through a series of axial imageviews, along the spinal axis 212, a label identifier C1, C1/C2, C2,C2/C3, and C3 corresponding to an appropriately labeled volume in theorthogonal sagittal or coronal view is displayed with each axial image.

To further illustrate, consider a first slice 1 and the associated image402 (image 1 of X) taken in the axial plane of the vertebra 402 of thespinal column 401. Label region C1 is intersected by slice 1 and thusthat particular axial image 402 will display “C1”. As the user continuesto traverse through other slices of the spinal column, correspondinglabels are displayed. For example, when the user reaches image 404(image 5 of X) created by slice 5, the intersection of the axial planeand the sagittal plane occurs within label region C1/C2 as such, thedisplayed image 404 would show a label of C1/C2. Similarly, when theuser traverses through to image 406 (image 10 of X) created by slice 10,a label of C2 is displayed in image 406.

In a further aspect of the present invention, the labeling by a user oftwo vertebras that are adjacent to an inter-vertebra disc will result inan automatic labeling of that inter-vertebra disc. The converse is alsotrue, meaning that a vertebra that is adjacent to two labeledinter-vertebra discs will be automatically labeled. This feature is onethat is configurable by the end user to be enabled or disabled.

In yet another aspect, as best seen in FIG. 7, the present invention mayinclude a method comprising: detecting spine segments with a 3Dvolumetric data recognition engine, displaying the detected segmentsoverlayed on top of the anatomical image(s), allowing a user to place alabel on one of the detected segment area, and automatically populatinglabels on all the detected segments based on the order of the segmentsthat are aligned.

In an even further aspect of the present invention, a user can providecentral points of a vertebra manually. This process may be accomplishedutilizing a mouse of other user input device. The user may click at thecenter portion of a vertebra or draw the curved line passing through thevertebral axis. This step can be performed before or after the manuallabeling process that was earlier described. The application program ofthe present invention utilizes this centering information in much thesame fashion as earlier described, i.e. to anchor the manual volumelabel among other things.

It may be problematic in some instances for a user to indicate the exactlocation for the placement of labels in the three dimensional volume.The three dimensional volume is typically the x-y location in the axialplane, or the z-y location in the sagittal plane, or z-x location in thecoronal plane. The process of placing the labels can be time consumingand require mental concentration for the placement of the mouse cursorin the exact location(s) along the spinal image in order to providerelevant labels. The present invention addresses this issue in a furtherembodiment that utilizes a spine center line. More specifically, spinedetection/segmentation techniques are utilized for locating the user'smouse cursor and the ultimate placement of labels. As best illustratedin FIG. 5A and the spinal diagram 500, the present invention locates theposition for the placement of a label by either restricting a user'smouse movement along a system detected spine center line 504 or byimplementing an automatic labeling that utilizes the detected spinecenter results.

A center line spine detection system that may be used in the presentinvention is described in U.S. Patent Application No. 2009/0202122,filed on Feb. 6, 2009, which is hereby incorporated by reference in itsentirety. The present invention is operable in a semi-automatic labelingmode and a fully automatic mode. The semi-automatic mode refers to theabove described methodology that utilizes the spine center linedetection to restrict mouse pointer movement. In this mode, the basicoperation of the inventive system is essentially the same as the earlierdescribed manual operation for spine labeling. The distinction lies inthe restriction that is placed on the movement of the mouse pointer 502.As a user moves the mouse pointer 502, the movement is dynamicallylinked to a spine labeling cursor 506. The labeling cursor 506 isrestricted to moving along the detected center line 504 and may also berestricted/snapped to specific point locations on the center line, suchthat the placement of the label is consistent, easier and faster. Inother words the typical erratic motion that may be exhibited by a useror the inaccurate placement of the label cursor away from the spine iseliminated. Furthermore, the time and effort required for a user to“zero-in” to a precise label location is also eliminated.

In operation, the detected center line 504 and the label cursor 506 maybe constantly displayed and visible to the user. The visible center line504 and label cursor 506 indicate where labels would be placed, as theuser moves the mouse pointer 502. Once the label cursor 506 has reacheda location that is satisfactory to the user, the user may take an actionsuch as clicking the mouse button to anchor a label.

In a further embodiment of the present invention, and as bestillustrated in the diagram 508 of FIG. 5B, a user may relocate thedetected center line 504. In operation, if a user is unsatisfied withthe detected center line 504, the user may select and drag one or moreindividual points along the detected line to a new location, and thusredraw the center line. As shown, the user may place the mouse pointer506 at a location point 510 along the detected center line 504. When theuser drags the mouser pointer 506 to a new location 512, a correctedcenterline 514 is then generated. The corrected center line 514 isgenerated via an interpolation process.

In the automatic mode of operation, automatic segmentation of individualspine structures along with center line detection processes areutilized. In this mode, when a user initializes spine labeling, all thespine labels are automatically identified and placed. The user is ableto modify the resulting label placements if desired. The modification ofthe resulting label placement may be accomplished in a manner consistentwith the above described semi-automatic label placement process of thepresent invention.

Having described the system and method of the present invention and anembodiment thereof, an exemplary computer environment for implementingthe described design and execution is presented next.

FIG. 6 shows an exemplary computing environment 600 that can be used toimplement any of the processing thus far described. The computingenvironment 600 may comprise a computer 612 including a system bus 624that couples a video interface 626, network interface 628, one or moreserial ports 632, a keyboard/mouse interface 634, and a system memory636 to a Central Processing Unit (CPU) 638. Computer 612 may alsoinclude a Graphics Processing Unit (GPU) or one or more other special orgeneral purpose processing units. A monitor or display 640 is connectedto bus 624 by video interface 626 and provides the user with a graphicaluser interface to view, edit, and otherwise manipulate digital images.The graphical user interface allows the user to enter commands andinformation into computer 612 using a keyboard 641 and a user interfaceselection device 643, such as a mouse or other pointing device. Keyboard641 and user interface selection device are connected to bus 624 throughkeyboard/mouse interface 634. The display 640 and user interfaceselection device 643 are used in combination to form the graphical userinterface which allows the user to implement at least a portion of thepresent invention. Other peripheral devices may be connected to remotecomputer through serial port 632 or universal serial bus (USB) drives645 to transfer information to and from computer 612. For example, CTscanners, X-ray devices and the like may be connected to computer 612through serial port 632, USB drives 645, or transferred to the serverdevice using DICOM communication protocol so that data representative ofa digitally represented still image or video may be downloaded to systemmemory 636 or another memory storage device associated with computer 612to enable processes and functions in accordance with the presentinvention.

The system memory 636 is also connected to bus 624 and may include readonly memory (ROM), random access memory (RAM), an operating system 644,a basic input/output system (BIOS) 646, application programs 648 andprogram data 650. The computer 612 may further include a Solid StateDrive (SSD), a hard disk drive 652 for reading from and writing to ahard disk, a magnetic disk drive 654 for reading from and writing to aremovable magnetic disk (e.g., floppy disk), and an optical disk drive656 for reading from and writing to a removable optical disk (e.g., CDROM or other optical media). The computer 612 may also include USBdrives 645 and other types of drives for reading from and writing toflash memory devices (e.g., compact flash, memory stick/PRO and DUO, SDcard, multimedia card, smart media xD card), and a scanner 650 forscanning items such as still image photographs to be downloaded tocomputer 612. A hard disk interface 652 a, magnetic disk drive interface654 a, a optical drive interface 656 a, a USB drive interface 645 a, anda scanner interface 658 a operate to connect bus 624 to hard disk drive652, magnetic disk drive 654, optical disk drive 656, USB drive 645 anda scanner 658, respectively. Each of these drive components and theirassociated computer-readable media may provide computer 612 withnon-volatile storage of computer-readable instruction, program modules,data structures, application programs, an operating system, and otherdata for computer 612. In addition, it will be understood that computer612 may also utilize other types of computer-readable media in additionto those types set forth herein, such as digital video disks, randomaccess memory, read only memory, other types of flash memory cards,magnetic cassettes, and the like.

Computer 612 may operate in a networked environment using logicalconnections with image capture devices such as MRI, CT scanners,Ultrasound, Positron Emission Tomography (PET) or X-Ray devices. Networkinterface 628 provides a communication path 660 between bus 624 andnetwork 620, which allows images to be communicated through network 620from any of the previously identified imaging devices, and optionallysaved in a memory, to computer 612. This type of logical networkconnection is commonly used in conjunction with a local area network(LAN). Images may also be communicated from bus 624 through acommunication path 662 to network 620 using serial port 632 and a modem664. Using a modem connection between computer 612 and imaging devicesmay be used in conjunction with a wide area network (WAN) or theinternet. It will be appreciated that the network connections shownherein are merely exemplary, and it is within the scope of the presentinvention to use other types of network connections between computer 612and imaging devices including both wired and wireless connections.

From the foregoing, it will be seen that this invention is one welladapted to attain all the ends and objects hereinabove set forthtogether with other advantages which are obvious and which are inherentto the method and apparatus. It will be understood that certain featuresand sub combinations are of utility and may be employed withoutreference to other features and sub combinations. This is contemplatedby and is within the scope of the claims. Since many possibleembodiments of the invention may be made without departing from thescope thereof, it is also to be understood that all matters herein setforth or shown in the accompanying drawings are to be interpreted asillustrative and not limiting.

The constructions described above and illustrated in the drawings arepresented by way of example only and are not intended to limit theconcepts and principles of the present invention. As used herein, theterms “having” and/or “including” and other terms of inclusion are termsindicative of inclusion rather than requirement.

While the invention has been described with reference to preferredembodiments, it will be understood by those skilled in the art thatvarious changes may be made and equivalents may be substituted forelements thereof to adapt to particular situations without departingfrom the scope of the invention. Therefore, it is intended that theinvention not be limited to the particular embodiments disclosed as thebest mode contemplated for carrying out this invention, but that theinvention will include all embodiments falling within the scope andspirit of the appended claims.

What is claimed is:
 1. A method programmed for execution in a computing device for labeling two or more digital image views of an anatomical target area, the method comprising: providing a first label for the anatomical target area included in any of the two or more digital image views; locating said first label to a center or clinically appropriate location of the anatomical target area; utilizing said first label to identify the anatomical target area in at least two of the two or more digital image views that intersect with said first label; and utilizing the location of said first label to predict a subsequent label for the anatomical target area included in any of the two or more digital image views based on the direction of movement and location of a cursor with respect to the anatomical target area, wherein said cursor is controlled by a user via a pointing device.
 2. A method in accordance with claim 1, wherein said first label is overlayed on the two or more digital image of the anatomical target area.
 3. A method in accordance with claim 1, wherein the two or more digital image views are orthogonal views of the anatomical target area.
 4. A method in accordance with claim 1, wherein the two or more digital image views are non-orthogonal views of the anatomical target area.
 5. A method in accordance with claim 1, wherein the two or more digital image views are planar views of the anatomical target area.
 6. A method in accordance with claim 1, wherein at least one of the two or more digital image views is a non-planar view of the anatomical target area.
 7. A method in accordance with claim 1, wherein at least one of the first and subsequent labels is a volumetric label.
 8. A method in accordance with claim 1, wherein the anatomical target area is a spine.
 9. A method in accordance with claim 8, wherein said first label identifies a vertebra or inter-vertebra.
 10. A method in accordance with claim 9, wherein said first label is centered on said vertebra or inter-vertebra and said first label is dimensioned to approximate outer boundaries of said vertebra or inter-vertebra, wherein said spine may be linearized and a volume of the vertebra or inter-vertebra is ascertained and identified.
 11. A method in accordance with claim 10, wherein an axis of the spine is located and utilized to align and anchor said first label across the two or more digital image views.
 12. A method in accordance with claim 10, wherein a first one of the two or more digital image views is on either a sagittal plane or a coronal plane, wherein a second one of the two or more digital image views is a first axial slice that is disposed at an angle relative to said first one of the two or more digital image views, wherein a third one of the two or more digital image views is a second axial slice that is disposed at an angle relative to said first one of the two or more digital image views, and wherein said first label is displayed in said second one of the two or more digital image views and said subsequent label is displayed in said third one of the two or more digital image views as at least a portion of the spine is traversed in said first one of the two or more digital image views using the cursor.
 13. A method in accordance with claim 9, wherein labeling two adjacent vertebra results in an automated labeling of the intervening inter-vertebra.
 14. A method in accordance with claim 9, further comprising automated labeling of vertebral and inter-vertebral regions when a user provides labels for two adjacent inter-vertebral or vertebral regions.
 15. A method in accordance with claim 1, wherein said first label is provided by having a user manipulate said pointing device, said pointing device being dynamically linked to said cursor, labeling cursor restricted to predetermined positions along a detected center line of the anatomical target area.
 16. A method in accordance with claim 15, wherein said detected center line of the anatomical target area is relocated by said user by utilizing said pointing device to drag a point along said detected center line of the anatomical target area to a new location, wherein a corrected center line may be provided and the related label may be aligned.
 17. A method in accordance with claim 1, wherein said step of locating said first label to said center or clinically appropriate location of the anatomical target area is performed automatically.
 18. A method programmed for execution in a computing device for labeling a plurality of spine segments of a spine included in an anatomical image, the method comprising: detecting the plurality of spine segments using a volumetric data recognition engine; displaying said detected spine segments overlayed on top of the anatomical image; allowing a user to place a label on one of said detected spine segments; and automatically populating labels on the remaining detected spine segments based on the order of the detected spine segments.
 19. A method programmed for execution in a computing device for labeling a plurality of spine segments of a spine included in an anatomical image, the method comprising: detecting the plurality of spine segments using a volumetric data recognition engine; displaying said detected segments overlayed on top of the anatomical image; and automatically populating labels on all of the detected spine segments based on the order of the plurality of spine segments.
 20. A method in accordance with claim 1, further comprising: determining a centerline of the spine; and associating said labels with said detected centerline of the spine. 